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Anti-dsDNA and anti-Sm antibodies do not predict damage in systemic lupus erythematosus

University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

D Ibañez

University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

D Gladman

University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

M Urowitz

University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada, m.urowitz{at}utoronto.ca

We aimed to determine whether anti-dsDNA and anti-Sm antibodies predict damage in systemic lupus erythematosus (SLE). Five-hundred inception patients from the University of Toronto Lupus Clinic were studied. Predictors assessed for the entire study period were: 1) raised anti-dsDNA on two consecutive occasions; 2) anti-dsDNA levels (normal, mildly or highly elevated); 3) presence of anti-Sm on any occasion. To account for disease duration, the following were assessed at three years post-inception: raised anti-dsDNA on two consecutive occasions; anti-dsDNA levels. These predictors were correlated with the following outcomes: 1) overall SLICC/ACR Damage Index (SDI) at the end of the study period; 2) frequency of damage in the cardiovascular, neuropsychiatric, musculoskeletal and renal components of SDI; 3) SDI at five years for the predictors assessed at three years post-inception.

In the multivariate analysis, presence of anti-DNA antibodies or of anti-SM were non-significant but sex, age at SLE diagnosis, disease duration, corticosteroid use and cumulative dose were strong predictors of damage. Raised anti-dsDNA on two occasions or anti-dsDNA levels in the three years post-inception patients did not predict damage at five years. The presence and levels of anti-dsDNA and anti-Sm antibodies do not predict damage in SLE.

Key Words: anti-dsDNA • anti-Sm • damage • outcomes • SLE

Lupus, Vol. 15, No. 5, 285-291 (2006)
DOI: 10.1191/0961203306lu2302oa


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